Efficacy and Safety of Intratympanic Steroid Treatment for Idiopathic Sudden Sensorineural Hearing Loss

Objectives: This study was planned to evaluate the efficiency and safety of Intratympanic (IT) injection of methylprednisolone (IT-MP) on idiopathic sudden sensorineural hearing loss (ISSHL) patients as an initial therapy, by weighing against the outcome with intravenously administered dexamethasone (IVDEX) treatment. Materials and Methods: A prospective, nonrandomized, comparative study was conducted for 50 patients presenting with ISSHL. Twenty-five patients were managed with intratympanic methylprednisolone as a single and initial treatment, and 25 with intravenous dexamethasone. The hearing level was described using the Pure Tone Average (PTA in dB) hearing level at four frequencies (0.5, 1, 2 and 4 kHz). Hearing gain was expressed as absolute hearing gain and relative hearing gain. Complete hearing recovery was defined as the final PTA within 10 dB of baseline. Partial recovery was defined as a final PTA with a ≥ 50% relative recovery. Results: Mean hearing improvement was significantly higher in IT MP group than in IV DEX group (50.7±22.11, versus 29.5±28.0, p<0.01). We found a high rate of relative recovery of hearing in IV DEX group, which was because of significant hearing level of the unaffected ear. Similar percent of patients in both groups had complete recovery, but in the IV DEX group 42% patients had no recovery (versus 10% in IT MP group).Conclusion: Intratympanic treatment of ISSHL may be a first choice , since it can be delivered in outpatient settings with no serious side effects and low complication rate.